Unilateral proptosis.

Unilateral proptosis. A series of 22 cases of unilateral proptosis at Angau Hospital, Lae, presenting over a 22-month period are analysed. The cases are discussed individually with emphasis on aetiology, treatment and prognosis. The differential diagnosis of unilateral proptosis is outlined.


Repair of perforating ocular wounds.

Repair of perforating ocular wounds.


Diaphyseal bone in rigid internal plate fixation. Experimental study of the weakening of canine long bone.


Quinacrine-banding analysis of the Philadelphia chromosome from five patients with chronic myelogeneous leukemia.


Cytomorphologic study on the atypical cells following cryosurgery for the treatment of chronic cervicitis. One hundred and twenty-nine patients of chronic cervicitis were treated by cryosurgery and periodically followed up by Pap smears and biopsies. Cytomorphologic studies were carried out on atypical cells following cryosurgery. Atypical cells were detected within four weeks. These were divided into two categories. The first group consisted of cells with abundant cytoplasm and occurred in sheets, aggregates and/or as isolated forms. Irregular nuclear borders were observed in 5.1 per cent and fine granular chromation pattern was found in 99.4 per cent. Irregular nucleolar borders were observed in 7.5 per cent and macronucleoli, over 2.5 microns in diameter, were disclosed in 11.3 per cent. Nuclei within 10 microns in diameter were observed in 56.6 per cent, and the maximum length was 20 microns. It was suggested that these cells were exfoliated from either basal cell hyperactivity or atypical reserve cell hyperplasia. The second group consisted of cells with scanty cytoplasm of bare nuclei and occurred in aggregates. Irregular nuclear borders were observed in 1.7 per cent and fine granular chromatin patterns were found in 99.7 per cent. Irregular nucleolar borders could not be encountered. Macronucleoli were observed in only 0.4 per cent. Nuclel within 10 microns in diameter were observed in 95.3 per cent and the maximum measured length was 15 microns. It was suggested that these cells could be derived from reserve cell hyperplasia or from immature squamous metaplasia. In conclusion, atypical cells following cryosurgery exfoliate from the regenerating tissue in which atypia is frequently observed. The cells of the first group have identical features with those observed in the cases of tissue repair; on the other hand, the cells of the second group were derived from reserve cell hyperplasia or from immature squamous metaplasia.


A comparison between measured and calculated changes in the lung function after operation for pulmonary cancer. Eighteen patients operated on for pulmonary cancer, the procedure varying from the removal of two segments to pneumonectomy, were subjected to measurement of the spirometric values VC, FEV1, FRC and RV preoperatively and 2-3 months postoperatively. The possibility of predicting the postoperative values from the number of segments removed was studied, partly with standard percentages (5.26%) per segment (method I), and partly with a percentage per segment in the affected area, calculated from the preoperative regional lung function tests using 133xenon. This latter test was carried out with a mobile apparatus using four detectors with tubular colimators and from the anterior surface of the thorax. Both methods of calculation gave, for the material as a whole, good agreement between the postoperative (measured) and the calculated values. However, with regard to certain patients, the regional lung function tests gave important information on preoperative reduced function in the affected area. In these patients, method No. II was by far the best for prediction of the postoperative values.


The use of 125I-labelled fibrinogen for determination of fibrin trapping in the lungs in patients developing the microembolism syndrome. The microembolism syndrome occurred in four patients out of a series of 15 patients with multiple injuries who were considered to run a risk of developing this syndrome. These four patients showed signs of fibrin trapping in the lungs, as demonstrated by the use of 125I-labelled fibrinogen and external detection over the lungs. It is, therefore, considered that this method can be used for diagnosing the microembolism syndrome. The fibrin trapping occurred at the onset of the progressive respiratory insufficiency. The time relation between the uptake of fibrin and the onset of the progressive respiratory insufficiency supports the theory of a causal connection between fibrin and pulmonary damage. Measurements of different coagulation and fibrinolysis factors in the blood were not able to discriminate between patients who developed the microembolism syndrome and those who did not.


The effect of phenobarbitone anaesthesia on blood flow and oxygen consumption in the rat brain. The influence of phenobarbitone anesthesia on blood flow (CBF) and oxygen consumption (GMRO2) was evaluated in the rat brain, using a method that quantitatively measures CBF in mainly cortical areas. The data were compared to those obtained in animals under fentanyl citrate analgesia. Body temperature and arterial CO2 tension were maintained close to normal values in all groups. With 50 mg/kg of phenobarbitone, CBF and CMRO2 were reduced by about 20%. With 150 or 250 mg/kg, further reductions in CBF and CMRO2 were observed. At 250 mg/kg, CBF was reduced to one third, and CMRO2 to about 50% of normal. The results suggest that little further reduction in CBF or CMRO2 can be expected if the dose of phenobarbitone is increased above 250 mg/kg.


A simple technique for the determination of the ventilatory response to rising arterial CO2 tensions, suitable for patients with neurological disorders. Patients with neurological disorders may have a reduced ventilatory response to a rising PaCO2. This is often unpredictable and may become apparent only when other complications, e.g. infections (pneumonia), occur or when the patient is subjected to general anaesthesia. This paper described a simple method suitable for screening patients who may have an impaired capacity of eliminating CO2 when stressed. Ventilatory changes were determined during the continuous recording of the CO2 concentration in end-tidal air in 20 healthy subjects, who were breathing first air and then gas mixtures containing 21% O2 and 2.5 or 5% CO2. A prediction interval with 90 and 95% probability limits was constructed for healthy individuals. The normally expected change in minute ventilation per m2 body surface area per change in PACO2 (delta versicle E/m2, l/min/delta PACO2, for this technique is also given.


Endometrial and endocervical brushing techniques with a Medhosa cannula. A new technique for obtaining endometrial material using the Medhosa Cannula is described. This method is also useful to obtain samples from the endocervix. The Medhosa Cannula is made of flexible plastic. It is 30 cm long and has thin fins on its distal end which, guided by an introduction cone, permit endometrial and endocervical brushing. Six hundred cases are reported. Concomitant histopathological studies were performed in 40 per cent of the patients. There were two false negative cytologic reports (0.88%) and one false positive (6.66%). This is a simple, rapid, innocuous and economical technique, thus fulfilling the prerequisites for routine cytodiagnostic methods. Adequate material was always obtained.


Prevention of hypertensive crises in patients with high spinal lesions during cystoscopy and lithotripsy. Three patients with high spinal lesions, admitted to the hospital for cystoscopy and lithotripsy, showed signs of severe hypertension due to mass reflex during this operation. This symptom was controlled with an intravenous drip of Arfonade¿, and the patients felt quite comfortable without any other anaesthesia. Other possibilities for handling such patients are discussed.


The cytologic diagnosis of breast lesions. In view of the increasing number of patients presenting with breast lesions, cytology was used as a first step diagnostic procedure. This is the first study of its kind in Spain. Material was obtained from 660 patients, either from spontaneous nipple secretion or by fine needle aspiration. Cytologic criteria for recognition of the different cell types in the smears are discussed. The accuracy of the method was high (2.6% false negatives; 4.1% false positives). The cytologic technique for diagnosing breast lesions is simple, rapid and economic as well as harmless and painless. It therefore fulfills all requirements for an early diagnostic procedure.


Patient material in multidisciplinary intensive care units. The patient material in the multidisciplinary intensive care unit of Uppsala University Hospital is compared with the material from a recently performed nation-wide study on different intensive care units. A registration chart to record intensive care work and a time and motion study of nursing personnel are presented. It is concluded that such records are necessary to allow valid comparisons of the need for intensive care beds and personnel in hospitals of different sizes and degrees of specialization.


Treatment of pre-eclampsia and eclampsia as a hypoperfusion syndrome. A therapeutical program in pre-eclampsia and eclampsia is presented. The results in 10 patients suggest that the same basic program as is used in the hypoperfusion syndrome can be used in pre-eclampsia and eclampsia: Chlorpromazin to combat vasoconstriction and dilate the vascular bed. Plasma expanders, plasma, albumin and glucose with electrolytes to fill up the dilated vascular bed and restore the tissue perfusion. Buffers to combat acidosis, oxygen to combat hypoxemia, hypertonic Mannitol to mobilize edema. Furosemide to force diuresis.


Tricyclic antidepressive poisoning with special reference to cardiac complications. Sixty-eight cases of tricyclic antidepressive (TCA) poisoning are discussed. Cardiac arrest occurred in 8 patients, preceded by minor ECG-abnormalities. Five patients died. All cardiac arrests arose within the first 24 h after TCA ingestion. Fifty-seven patients developed ECG-abnormalities, of which 84% began within the first 6 h after TCA ingestion. ECG-abnormalities and other symptoms (respiratory arrest, coma, convulsion and hypotension) often occurred in the same patients. Treatment is described, and cardiac monitoring for at least the first 24 h is recommended. In cases of severe cardiac (ECG) abnormalities, monitoring is recommended until no ECG abnormalities are observed for at least 12 h. In conclusion, the unrestricted use of TCA is cautioned against, since TCA must be regarded as potentially cardiotoxic.


A prospective study concerning mental disorders of a total population investigated in 1947, 1957 and 1972. The Lundby study III (preliminary report).


Malignancy associated changes in sputum: a correlated study of 315 patients.


Psychiatric disorders in Finland.

Psychiatric disorders in Finland.


Psychological responses to war stress.

Psychological responses to war stress.


Rural vaucluse: two surveys on the prevalence of mental disorders. Summary of data.


The effect of anesthesia on intraoperative and postoperative bleeding during abdominal prostatectomies: a comparison of neurolept anesthesia, halothane anesthesia and epidural anesthesia. Intraoperative blood loss was measured during abdominal prostatectomies in 213 patients anesthetized with neurolept anesthesia, halothane anesthesia and epidural anesthesia. In 55 of these patients, postoperative bleeding was also measured. The average intraoperative blood loss with neurolept anesthesia was 8.2 +/- 5 ml/min, with halothane anesthesia 6.6 +/- 6.3 ml/min and with epidural anesthesia 3.8 +/- 2.3 ml/min. The difference of blood loss in the epidural group and in the groups receiving general anesthesia is highly significant. Average systolic and diastolic blood pressures were lower during operation in the epidural group than in the other two groups. Statistical analyses failed, however, to show a significant correlation between blood pressures and blood loss in the individual patient. Thus, the ultimate explanation for the diminished bleeding associated with epidural anesthesia is not definitely ascertained. The average postoperative bleeding was not significantly different among the three anesthetic groups.


Need of psychiatric services in the Finnish social psychiatric investigation.


Extrinsic nervous control of the ileo-cecal sphincter in the cat. The influence on the ileo-cecal sphincter (ICS) of electrical efferent stimulation of the splanchnic, lumbar colonic and vagal nerves and of intestinal distension was studied in anesthetized cats. A new flow-recording technique was designed. Reponses in the ICS to stimulation were recorded as changes in the transsphincteric flow. The response in the ICS was compared to the responses in the intestine proximal and distal to the sphincter. Sympathomimetic amines and autonomic blocking drugs were used in order to elucidate the autonomic mechanism by which the responses to stimulation were mediated. On the basis of the observations made the following conclusions were drawn: 1. Both the splanchnic and the lumbar colonic nerves exert a contractile influence on the ICS. The effect is mediated via excitatory adrenergic alpha-receptors. 2. The ICS contains inhibitory adrenergic beta-receptors. 3. Activation of the vagal nerves causes a decrease of the transsphincteric flow which is at least partly due to a direct nervous effect on the sphincteric muscle. A cholinergic mechanism is suggested. 4. Intestinal distension elicits contraction of the ICS. This excitatory intestino-ileo-cecal sphincteric reflex is a spinal reflex and mediated via adrenergic fibres within the sympathetic nervous system acting on alpha-receptors.


The cytodiagnosis of malignant lymphomas and Hodgkin's disease in cerebrospinal, pleural and ascitic fluids. One hundred twenty-six fluids from 98 patients with malignant lymphomas have been examined cytologically. The overall accuracy was 88 per cent with only one false positive in 126 fluids. False negatives were highest in the cerebrospinal fluid, which may reflect poor exfoliation of malignant lymphoma cells when the leptomeninges are involved. We have found exfoliative cytology to be an accurate method of diagnosing lymphomatous involvement of the leptomeninges, pleura and peritoneum and when a cytologic diagnosis of involvement by lymphoma is made it is almost as accurate as a histologic diagnosis. Nuclear characteristics and selected histochemical methods will allow classification of many types of lymphoma in bytologic preparations.


Cytologic evaluation of the nasal epithelium in patients with hay fever. Seventy two cases of hay fever which were confirmed by scratch tests were used to estimate the state of the epithelium of the mucous membrane of the nose. Cells of the respiratory eptihelium were found in smears from the surface of the mucous membrane in 79per cent of the cases of hay fever. Compared with nose smears from the control group, nose smears from patients with hay fever contained many more cells, predominantly goblet cells. In the cases of hay fever, a very rich cellular material was discovered in the smears from the surface of the mucous membrane of the nose. The chief characteristic feature of those cells is that they appear in clusters. Numerous cells from the respiratory epithelium, mostly goblet cells, were found in nose smears from patients with hay fever. The patterns of smears observed in patients with hay fever are helpful to us in the differential diagnosis in the rhinological laboratory.


Mental health and living conditions in a fishing community in northern Norway.


An intensive study of mental disorders and related social variables in different neighbourhoods in Oslo.


Physical and mental illness in a Lapp and Norwegian population.


The "Tromvika" project.

The "Tromvika" project.


The diagnostic value of cul-de-sac aspiration in the detection of ovarian carcinoma.


Psychiatric morbidity in Berlevåg.

Psychiatric morbidity in Berlevåg. For the population of Berlevåg the psychiatric morbidity is 37.3% registered with the Harvard health and family life survey and 20.5% with clinical estimates (life prevalence). The actual psychiatric morbidity (point prevalence) is assumed to be markably less than 20%. By checking psychiatric cases seen by the public health officer in the first half of 1973 and by 2 psychiatrists during field work the summer of 1974, the morbidity not registered yet, predominantly consists of borderline neurotic states, who by many psychiatrists will be considered as being within the limits of normal variation.


Swedish Co-operative CCU Study. A study of 2008 patients with acute myocardial infarction from 12 Swedish hospitals with coronary care unit. Part I. A description of the early stage. Part II. The short-term prognosis.


Cytologic findings in female and male offspring of DES treated mothers. Data on vaginal, cervical, and endocervical samples and urine specimens of 84 female offspring exposed to diethylstilbestrol in utero and 43 controls have been presented. The colposcopic and histopathologic findings were correlated with the cytologic findings. Our preliminary findings indicate that the cytologic technique is reliable as screening test for vaginal epithelial changes in the DES-exposed females provided the sampling procedure is adequate. In 79 male patients, 42 DES-exposed and 37 controls, the pre-massage urine, the prostatic fluid, the post-massage urine and aspirate of cysts of the epididymis when existing were examined by cytologic techniques. No tumor cells were found in the cytologic specimens of the exposed and unexposed male and female offspring.


Orthopedic effect of the extraoral chin cup appliance on the mandible. An anatomic photoelastic model of a human skull was constructed with the use of individual simulants for teeth, bone, and periodontal ligaments. The following effects of extraoral chin cup traction were observed: 1. Stresses were noted in the area of the pterygoid plates of the sphenoid bone due to the insertion of the simulated external pterygoid muscle. 2. Because of direct contact of the condyle against the posterior surface of the glenoid fossa, forces were seen to be transmitted to this anatomic area. 3. Stress trajectories followed the trabecular pattern of the anatomic configuration of the mandible. 4. Beginning at the apices of the incisor teeth, the stresses emanated through the body, the angle and retromolar triangle of the mandible, radiating in a posterosuperior fashion and concentrating at the neck of the condyle. 5. Selected sectioning of the mandibular model showed evidence of stress concentration at the lingual aspect of the angle and retromolar area as well as at the condylar neck at the level of the external pterygoid muscle insertion. The effects of orthopedic forces produced by an extraoral chin cup in this study are correlated with the histologic and clinical observations during the utilization of this appliance in the treatment of Class III malocclusion.


New norms for the mesh diagram analysis.


Oral hygiene in the orthodontic practice: Motivation, responsibilities, and concepts. This article describes our current oral health program. This program will continue to change as we learn more effective ways to communicate and offer instruction. The orthodontist and his staff are in a unique position to help patients become concerned about oral health. The cumulative effect of such patient educations is tremendous since hundreds of patients can be affected. Improving the effectiveness of an oral health program is an excellent opportunity to expand our service as health-care practitioners. A survey of dental home-care programs shows that a relationship exists between dentists' attitudes toward their programs and the degrees of success. Usually an oral health program will not become effective unless the orthodontist is motivated and accepts responsibility for motivating his staff and patients. The extent to which an orthodontist is enthusiastic and involves himself in oral health motivation will be reflected in how enthusiastic his auxiliaries are when instructing patients. If an orthodontist delegates both the motivational and instructional aspects of oral hygiene improvement to auxiliaries, his program will fall short of its potential effectiveness. A comment at each appointment telling the patient about his cleaning effectiveness is especially helpful. This feedback should be offered with kindness, objectivity, and respect for the patient. If an orthodontist feels impatient or frustrated, the patient will perceive this; perception of this negativity will frequently result in patient resistance to instruction and cooperation. When an orthodontist offers guidance in oral hygiene with sincere interest and respect, patients usually respond to his concern and become receptive to improving themselves. The extent to which we recognize a patient's "potential" to achieve excellent oral health, regardless of his present condition, will affect our ability to motivate that person. Our respect for patients will increase when we accept that nearly every patient has the inner capability for achieving excellent oral health. We have an opportunity to help patients recognize this potential. When patients recognize more of their potential, self-respect grows and they gain interest in caring for themselves.


The assessment of occlusal features for public health planning purposes.


Preorthodontic guidance and the corrective mixed-dentition treatment concept. A concept of corrective orthodontic treatment starting at an earlier age than usual has been discussed and illustrated. Realignment of terminology has been prosposed to give a clearer picture of the circumstance of malocclusion and its need for correction at an early age. A group of 300 patients treated in three categories were compared as to length of treatment time. Three groups of twenty-five patients treated correctively after preorthodontic guidance in the mixed dentition and only in permanent dentition were analyzed cephalometrically. The following conclusions can be reached: 1. Corective mixed-detition orthodontic treatment is a valid, safe, and reliable peocedure. 2. It encompasses both preorthodontic guidance and full-banded orthodontic treatment. 3. Current terminology is confusing and controversial...


Editorial: The Broadbent-Bolton standards book.


Clinical treatment with the Begg appliance. In a series of three articles, clinical treatment with the Begg appliance has been discussed. In the March, 1973 article, the standard procedures in the three stages commonly used in the Begg method were illustrated in a series of eight cases showing the wide range of orthodontic treatment possibilities of this method. The February, 1974 article contained a case report that illustrated some of the problems connected with orthodontic observation, diagnosis, Begg treatment, and retention. In this third article, due attention has been given to common problems of the chairside worker as encountered in daily practice. Certain comments have been offered, particularly with regard to child dental care and orthodontic guidance procedures of the growing child. A treatment approach, based on an individual optimum for each patient is discussed, following the course of treatment of three cases (Figs. 1, 2, and 4) with unfavorable jaw patterns and dental problems. These are compared with others having better anatomic proportions (Figs. 3 and 5). In the last case (Fig. 5) diagnosis and treatment planning are once again reviewed. The essential decision to be made for each orthodontic treatment, namely, whether and which teeth must be removed, is discussed and illustrated. In all cases, attention has been given to the portrayal of methods and technical details through the three stages of Begg treatment.


The role of fibroblasts in the remodeling of periodontal ligament during physiologic tooth movement. Our findings indicate a cellular basis for the connective tissue remodeling which takes place during physiologic tooth movement. This cell is the fibroblast which is capable of synthesizing and degrading collagen simultaneously and, utilizing this ability, the orderly control of collagen remodeling within the periodontal ligament is possible. It is suggested that this cellular basis of connective remodeling will have a direct significance for orthodontic tooth movement once control mechanisms have been established.


The American Medical Association and the Federal Trade Commission.


Second premolar serial extraction.

Second premolar serial extraction. Serial extraction of mandibular second premolars should be considered if they are impacted or in cases with moderate arch length deficiency combined with an absence of dentofacial protrusion. The favorable dental changes associated with this approach greatly minimize future orthodontic treatment complexity and time.


Editorial: Constituent Society presidents report on current orthodontic issues. Part I.


Letter to the editor: Baby boom questioned.


Letter: A hazard of the East Radcliffe respirator.


Phillip Gett memorial lecture awareness in anaesthesia. An attempt is made to assess the importance of awareness and dreaming in patients subjected to light anaesthesia with muscle relaxants. Frank awareness is probably an uncommon event if the anaesthetic be given competently, but unpleasant dreams can, in some circumstances, be significant.


Low-output syndrome as a complication of open-heart surgery in 85 patients. Low-output syndrome (LOS) was manifested after cardiopulmonary bypass in 33% of the patients undergoing mitral valve replacement in 12% of those submitted to aortic valve surgery, and in 16% of the patients on whom coronary artery bypass surgery was performed. It was also a frequent complication of multiple valve procedures, LOS was the commonest cause of hospital deaths after valve or coronary bypass surgery. The development and prognosis of LOS is dependent on several factors which may be related to the preoperative state, intraoperative events and postoperative treatment. Of these, one of the most important prognostic factors that emerged in this study was perfusion time. It was longest in the group of the 14 patients who died of myocardial failure on the operating table, shortest amongst the 28 patients who survived LOS, and of intermediate length for the 43 patients who died of LOS postoperatively. The differences between the groups were statistically significant. The mechanism of myocardial injury is reviewed. The incidence of various extracardiac complications increased during th postoperative course in proportion to the duration of LOS. Many of these complications resulted in a fatal outcome even when the patient was succesfully weaned from inotropic pharmacological support. There was more survivors in the group treated with dopamine than in the groups treated with isoproterenol or a combination of these drugs.


Letter: Acute granulocytic leukemia in the elderly.


The fine structure of the coronal root region of premolar teeth in dogs.


Secretion of parotid IgA in relation to gingival inflammation and dental caries experience in man.


Patterns of mineralization in the roots of premolar teeth in dogs.


Protection against dental caries in rats by glycerophosphates or calcium salts or mixtures of both.


Oxytalan-vascular relationships observed in histologic examination of the periodontal ligaments of man and mouse.


Phospholipid compositions of rat, rabbit and bovine dental pulp.


Similarity of bacteriocins of Streptococcus mutans from mother and infant.


Fatty acid compositions of phospholipids in rat, rabbit and bovine dental pulp.


Pellicle formation on hydroxyapatite splints attached to the human dentition: morphologic confirmation of the concept of adsorption.


The twitch-contraction characteristics of opossum jaw musculature.


The relationship between sugar metabolism and potassium translocation by caries-inducing streptococci and the inhibitory role of fluoride.


Streptococcus milleri (Guthof); an indigenous organism of the human oral cavity.


Streptococcus mutans in the mouths of children with congenital sucrase deficiency.


Ameloblastic fibroma. Case report.

Ameloblastic fibroma. Case report. A rare odontogenic tumour, ameloblastic fibroma, is presented as a case report and briefly discussed.


Histological studies of an adhesive paint-on restorative for cervical erosions. A histological study of the response in the pulps of human teeth to cervical restorations made with a composite resin following etching of the enamel for 2 minutes with 50 per cent phosphoric acid showed moderate inflammation after 14 days. Three specimens showed normal structure after 98 days. Teeth restored without etching showed only slight inflammation.


Facial pain.

Facial pain. The problems of diagnosis of pain are examined and the more important extra-oral causes which may complicate the diagnosis are discussed. The need for a complete and careful history and the use of thorough examination procedures is stressed in order that intra-oral causes may be eliminated.


Acanthomatous ameloblastoma in a follicular cyst. Case report.


Comparison of impact strength of joints made with four dental cements. Tests on 4 cements showed the impact strength of joints between gold and tooth structure varied somewhat with the surface roughness and cementing force. Polycarboxylate provided stronger joints although the results were variable. Little difference was found between zinc phosphate, zinc oxide-eugenol with polymethyl methacrylate, and zinc oxide-eugenol with ortho ethoxybenzoic acid.


Time of natural exfoliation of deciduous teeth. Over 6000 naturally exfoliated deciduous teeth were sent in to the Department of Preventive Dentistry, University of Sydney over a 10-year period 1964-1974. Adequate histories for 2,828 teeth from 1,558 children were used to determine average ages of children at time of exfoliation of the teeth. Teeth lost at an earlier age were most frequently returned with similar numbers of left and right teeth. There were no differences in exfoliation times for corresponding teeth from left and right sides of arches. Girls had earlier exfoliation times than boys and lower teeth were generally exfoliated prior to upper teeth.


Is your life assurance policy still worthwhile?


Letter: Is that apicoectomy really necessary?


Letter: Dentistry in France.

Letter: Dentistry in France.


Infective endocarditis in a Sydney teaching hospital--1962-1971. This report represents a comprehensive review of infective endocarditis in a major Australian centre between the years 1962 and 1971. During the later years of this study prosthetic valves were inserted in significant numbers and cardiac surgery became available in the treatment of endocarditis. The following major points emerged. There has been no reduction in the incidence of this disease within the period of study. A higher percentage of cases have followed surgery, particularly cardiac. There has been a decreased number of cases following dental extraction or urological surgery. A change in the pattern of the infective organisms was observed, particularly an increase in Staphylococcal infections, although Strep. viridans was the most frequent infecting agent. Infected prosthetic valves accounted for 11% of cases in the latter five year period, Staphylococcal infections being responsible for the majority of these cases. The mortality for prosthetic infections was 80%, and a loss of anticoagulant control contributed to death in 42% of patients. There was a reduction in mortality due to endocarditis from 39% between 1962 and 1966 to 24% between 1967 and 1971 (P less than 0-05).


Haemodynamic effect of intravenous verapamil in controlled atrial fibrillation. The haemodynamic effect of intravenous verapamil was assessed in eight digitalised patients with atrial fibrillation, at rest and on exercise. The reported regularisation of the ventricular rate in atrial fibrillation with verapamil, was also examined. The only significant haemodynamic effect attributable to the drug was an increased stroke volume which was in accordance with significant heart rate slowing which occurred at rest and both during and after exercise. There was no significant change in cardiac output. Although the heart rate slowed in all studies, regularisation of the R-R interval did not occur.


The bone marrow colony forming cell in megaloblastic anaemia and iron deficiency anaemia. Bone marrow samples from patients with megaloblastosis and iron deficiency have been assayed for their content of in vitro colony forming cells (CFC), and compared with a group of normal patients. The concentration of these cells was found to be significantly increased in the megaloblastic group, while their content in the iron deficient patients was slightly higher than the controls. An in vitro thymidine suicide procedures was utilised to assay the proportion of CFC in the S phase of the cycle. This was found to be increased in the megaloblastic group and only slightly increased in the iron deficient group. The findings in megaloblastosis seem to be consistent with the concept of impaired DNA synthesis. As the CFC monitors an early granulocytic progenitor these data suggest some impairment in DNA synthesis or an abnormal increase in amplification in this myeloid stem cell compartment. Such alterations in granulopoietic proliferation may contribute to the ineffective granulopoiesis of megaloblastosis and accordingly may be an important factor in the development of neutropenia sometimes associated with this condition. The slightly increased CFC concentration and altered cell cycle status found in iron deficiency suggest that iron is not a major requirement for granulopoiesis.


Inhibition of intestinal amino acid absorption by unconjugated bile salt in vivo. The intestinal absorption of five amino acids studied (L-lysine, L-glycine, L-leucine and L-tyrosine) and one dipeptide (glycylglycine) was significantly inhibited by the deconjugated bile salt, sodium deoxycholate, in rats in vivo. It is suggested that inhibition of absorption of amino acids and dipeptides by unconjugated bile salts may contribute to hypoproteinaemia in patients with the contaminated small-bowel syndrome.


T4 thyrotoxicosis with normal or low serum T3 concentration. Eight patients are described with elevated plasma thyroxine (T4) concentrations, but normal or low plasma triiodothyronine (T3) concentrations by radioimmunoassay. All were suffering also from non-thyroidal illness, which in six cases was severe, and in two fatal. The two patients in reasonable general health were acromegalic. It is possible that in sick thyrotoxic patients there is an impairment of peripheral conversion of T4 to T3, similar to that occurring in sick euthyroid patients. However, further proof of thyrotoxicosis must be obtained in patients with high T4 and normal or low T3 levels by studying the response of the pituitary to TRH. Meanwhile, in the sick or elderly, estimation of serum or plasma T3 concentration may not be a good screening test for thyrotoxicosis.


Acinetobacter anitratus infections in man. During a period of 17 months, 142 strains of Acinetobacter anitratus were isolated from 140 patients. They were examined for biochemical characteristics, antibiotic susceptibilities to 15 chemotherapeutic drugs and clinical and epidemiologic features. Biochemical studies were necessary for positive identification of this gram negative rod. Many isolates were susceptible to kanamycin, gentamicin, polymixin B, cotrimoxazole and nalidixic acid. Most isolates were hospital acquired and had been cultured from a number of anatomic sites in the presence of a variety of clinical situations. Acinetobacter anitratus was the primary infecting organism in two cases of septicaemia (one fatal), two pneumonias, two wound infections and six urinary tract infections. Because of its potential pathogenicity this organism should not be dismissed as a harmless commensal by laboratory staff and clinicians.


Adenine phosphoribosyltransferase deficiency: its inheritance and occurrence in a female with gout and renal disease. A deficiency of adenine phosphoribosyltransferase (APRT) enzyme activity to approximately 40% of normal has been found in erythrocytes from a young woman aged 24 years, who had suffered from recurrent gouty arthritis since 11 years of age. She also demonstrated considerable, although asymptomatic, renal impairment with a creatinine clearance of one-third normal. Her father had suffered from gouty arthritis but had a normal APRT activity; he was obese, had a high purine intake and was a regular beer drinker. The patient's mother was asymptomatic with a normal serum urate concentration, but demonstrated a similar reduction in APRT activity to that of her daughter. Eleven other asymptomatic members of the family also demonstrated a similar reduction in APRT activity in erythrocyte lysates. The pattern of inheritance was consistent with autosomal transmission. Concentrations of phosphoribosylpyrophospate (PRPP) in erythrocytes were within normal limits both in the subjects with deficient, and in those with normal, APRT activity. Partial purification of APRT enzyme from erythrocytes of the index case did not reveal any difference from the normal enzyme as far as Michaelis constants, heat stability, or mobility in polyacrylamide gel was concerned. No primary abnormality of lipoprotein metabolism was demonstrated either in the propositus or in other members of her family. Study of urate metabolism in the propositus indicated that, although urate production was within the normal range in absolute terms, there was increased incorporation of glycine into produced urate, usually taken as one index of de novo urate production. Impaired renal excretion of urate was also shown. Although detailed study of urate metabolism has not been undertaken in other family members with APRT deficiency, no conclusive relationship has yet been demonstrated between APRT deficiency and disordered urate metabolism.


Epidemic polyarthritis: a cytological, virological and immunochemical study. A patient with epidemic polyarthritis was studied within 48 hours of onset when specific serum antibodies were still low. The synovial fluid showed a fall in hyaluronic acid level and rise in protein levels though the immune globulins, and especially IgM, rose to a lesser degree and remained well below the levels in the serum. Attempts to grow virus from synovial fluid or blood lymphocytes failed despite the use of several new techniques. The complement components C'3 and C'4 were not depleted in serum or synovial fluid. The synovial fluid was devoid of neutrophil leucocytes, and contained predominantly monocytes and macrophages which were remarkable for mitotic and for enhanced and indiscriminate phagocytic activity. From this and other evidence, an explanation is proposed for the cytological response and difficulties in recovering infective virions in virus-induced arthritis. No virus antigen was detected in the supernatant synovial fluid and electron microscopy showed virus-like particles only in cytolysosomes.


Pyelo-ureteritis cystica associated with a urinary tract infection due to a coagulase-negative staphylococcus. A young female presenting with a history suggestive of renal colic was found by intravenous pyelography to have Pyeloureteritis Cystica. In association with this condition she had a urinary tract infection due to a coagulase-negative staphylococcus. Following a two week course of appropriate antibiotic therapy, her urine became sterile and repeat pyelography revealed no abnormality.


Rational therapy for thyroid storm.

Rational therapy for thyroid storm. An approach to the management of patients with thyroid storm is described. The treatment regimen, which is directed against the abnormalities as they are presently understood, incorporates: (a) Propranolol to inhibit the catecholamine-mediated peripheral effects of the circulating thyronines; (b) Propylthiouracil to inhibit thyroid hormone synthesis and to inhibit peripheral conversion of thyroxine to triiodothyronine (T3), the predominant source of T3 production; (c) Iodine to block the glandular release of thyroid hormones; (d) Dexamethasone along with general supportive therapy. The regimen has been used for a 13 year old schoolgirl with thyroid storm, and the induced rapid fall in serum T3 levels is illustrated. It has also been used in patients with florid thyrotoxicosis undergoing emergency surgery and has resulted in marked clinical improvement associated with rapid decreases in serum T3 levels. It is a simple and efficient regimen, rendering cumbersome forms of therapy such as plasmapheresis and peritoneal dialysis unnecessary.


Candida thyroiditis--treated with 5 fluoro-cytosine. A case of Candida thyroiditis in a patient with Goodpasture's Syndrome is described. Factors predisposing to the infection were neutropenia and the concomitant use of antibiotics and immunosuppressive agents. The patient was successfully treated with 5 fluoro-cytosine (5 f-c) and surgical drainage.


Decreased capacity to metabolize diphenylhydantoin in a patient with hypersensitivity to warfarin. A 48 year old man with normal hepatic function presented with abnormally prolonged bleeding following orally administered warfarin. Warfarin and diphenylhydantoin are known to be hydroxylated in the liver. To investigate the possibility of the patient having a metabolic (hydroxylating) defect, his ability to metabolize diphenylhydantoin was studied, as it would have been unethical to administer warfarin again. Parallel studies were carried out on two healthy subjects as a basis for comparison. On three separate occasions the elimination half-life for diphenylhydantoin in the patient (158, 87, 72 hours) was significantly longer than those obtained in the normal subjects (31 and 32 hours). This difference was most probably due to decreased hydroxylation of diphenylhydantoin to 5-(p-hydroxy-phenyl)-5-phenylhydantoin since his urinary elimination of this substance was demonstrated to be significantly less than that of the normal subjects. The results suggest that this patient had a reduced capacity to hydroxylate diphenylhydantoin, and this defect in liver hydroxylation may explain his increased sensitivity to warfarin.


Synchronous combined abdomino- thoraco-cervical (oesophagectomy). A synchronous combined abdomino-thoraco-cervical oesophagectomy with an abdominal and a thoracic team working simultaneously, is advocated. The method is described. The necessity for wide excision of the oesophagus is stressed, and the routine use of the stomach for reconstruction is advised. This approach may be used for both benign and malignant conditions.


Early gastric carcinoma.

Early gastric carcinoma. Seven cases of early gastric carcinoma are reported. This condition by definition refers to a carcinoma confined to the mucosa and submucosa only. The definition depends upon the depth of spread and not the surface area covered by tumour or the period over which it is believed to have been present. Each patient had a history indistinguishable from one of benign ulceration. All seven patients had barium meal studies, and in only two was the possibility of malignancy raised. In the other five patients the ulcers demonstrated radiologically were considered benign. Fibreoptic endoscopy was done in six cases; in three the appearances were suspicious of malignancy, and in the remaining three the lesions appeared benign. Biopsy specimens taken at endoscopy contained carcinomatous tissue in all six cases. The patients all had partial gastrectomy, and no recurrence has yet been found. The longest follow-up period is 36 months.


A major advance in the management of pneumatosis coli. A new treatment for gas cysts of the large bowel is described which involves the continuous inhalation of a high concentration of oxygen over a five-day period. Two patients with incapacitating symptoms due to diffuse pneumatosis coli were treated by this method. Oxygen therapy resulted in remission of symptoms and disappearance of cysts in both cases. The physiological basis of this simple, effective therapy is discussed, together with the precautions necessary in its use.


Large-bowel polypectomy via the colonoscope: experience with 80 polyps. The experience of two colonoscopy units in managing 88 patients referred with 114 suspected colonic polyps are presented. Almost a quarter of the suspected polyps were artefacts, while some actual polyps were not visualized at the initial colonoscopy. All but 10 of the confirmed polyps were successfully snared. Morbidity was low. Five of the polyps were malignant. The technical aspect of snaring and of setting up colonoscopy units are discussed. It is considered that colonoscopic polypectomy is the optimum management of colonic polyps.


Ileocaecal tuberculosis.

Ileocaecal tuberculosis. A retrospective study of 92 cases of ileocaecal tuberculosis, carried out at the Institute Hospital, New Delhi, is reported. The maximum incidence of the disease appeared to be between the ages of 20 and 40 years. There were 57 females and 35 males in the series. The majority of patients had symptoms for more than a year before they presented for treatment. Varying grades of intestianl obstruction constituted the usual clinical presentation, 44% of patients having subacute and 16% acute intestinal obstruction. Perianal fistula and abscesses were not seen. Most patients had no evidence of pulmonary tuberculosis. Barium X-ray studies were very helpful in the diagnosis. Bowel resection or short-circuiting gave very satisfactory results.


Suggested new rules for exploration of the common bile duct at cholecystectomy. Traditional indications for exploration of the common bile duct have been made anachronistic by developments in operative cholangiography. A new technique of contact cholangiography, described in this paper, improves the precision of operative cholangiography and allows the traditional indications for exploration to be modified. A new set of guidelines for exploration of the common duct, based on high-quality operative cholangiography, is outlined, and the place of the supraduodenal and transduodenal routes for exploration is discussed. The results of the application of these policies in a series of 120 cholecystectomies are presented.


The use of a tongue flap for the repair of defects following radical surgery of the head and neck. Tongue flaps can provide up to 100 square centimeters of mucosal surface for the repair of defects in the oral cavity or upper pharnyx. They provide an acceptable alternative to the use of pedicled skin flaps for the repair of many small to medium sized defects which occur following radical cancer surgery.


Hiatal hernia repair by posterior gastropexy. Posterior gastropexy was used in the repair of seventy-seven hiatal hermias from 1970 to 1975, after the fashion of Lucius D. Hill, of Seattle. The operations were performed by one author and reviewed by the other. The rationale and technique of the operation are discussed. Ten patients were lost to follow-up. Fifty-six patients were greatly imporved or cured, ten were imporved but still had some symptoms, while only one was unimproved. We conclude that posterior gastropexy is an effective, simple, and safe operation for the treatment of reflux associated with hiatal hernia.


Ovarian cysts in childhood.

Ovarian cysts in childhood. This is a review of cases of ovarian cyst encountered in childhood in the Manchester children's hospitals. The patients presented with acute or recurrent abdominal pain or an abdominal or pelvic mass. The commonest cyst found was a teratoma, which was discovered because of its size or because of a complication. All but one of the girls with teratomas had not reached puberty. After puberty the cysts were follicular or luteal in type, although there was one case of cystadenoma. Complications in the form of torsion, rupture which haemoperitoneum or haemorrhage into the cyst were common. Treatment consisted of ovarian cystectomy, oophorectomy or salpingo-oophorectomy, and the results were satisfactory.


Cerebral metastasis from melanoma.

Cerebral metastasis from melanoma. Fifty-seven patients suffering from melanotic cerebral metastases are reviewed. The nature and course of the primary lesion, the clinical history of the cerebral metastases and the results of treatment are discussed. Radiotherapy, chemotherapy, surgery and immunotherapy formed the basis of treatment.


The natural history of osteoid osteoma.

The natural history of osteoid osteoma. A long-term follow-up of three patients suffering from osteoid osteoma who have not undergone surgery is reported. Only eight similar cases have been reported in the literature. It is shown that over a period of years the pain of osteoid osteoma eventually disappears but the radiological appearance may remain unaltered or gradually resolve. Surgical management of osteoid osteoma is advised because of the prolonged symptoms.


Chondromalacia of the patella.

Chondromalacia of the patella. Where chondromalacia of the patella is resistant to conservative treatment, and where the existence of a Crooks ridge can be inferred from the clinical or X-ray findings, then an operative search for such a ridge, with trimming both of the ridge and of the affected area of the patella, offers a more promising surgical solution than other minor operative procedures, and a less drastic solution than patellectomy.


Fibromuscular hyperplasia of the iliac arteries. Fibromuscular hyperplasia is an uncommon disease of arteries with an unknown aetiology and an obscure natural history. It occurs rarely in the iliac vessels and may cause intermittent claudication. Two cases of fibromuscular hyperplasia of these arteries are reported. Both patients are middle-aged women. One presented with intermittent caludication and has been treated by aortofemoral bypass. The other is at present symptomless; the diagnosis was made in the course of the investigation of an abdominal bruit. Some features of the condition are discussed.


End thoracic duct presurres in man.

End thoracic duct presurres in man. Thoracic duct end pressures have been measured in a conscious patient undergoing cannulation in an attempt to remove serum blocking activity. Pressures were measured during rest, coughing, straining and laughing during the last-mentioned activity pressures of the order of 85 mm Hg were recorded. It is suggested that formal ligation of the cannula at the termination of treatment.


Ruptured iliac aneurysms.

Ruptured iliac aneurysms. Iliac aneurysms are uncommon as compared with aneurysms of the abdominal aorta. Rupture is the most serious complication of aneurysms of both vessels. Considerable attention has been focused on the management of ruptured abdomonal aortic aneurysms, but ruptured iliac aneurysms have received little notice. The problems in the management of ten ruptured iliac aneurysms, seen over the last five years, together with the rarity of other reports of this condition, have stimulated this review.


Characterization of L5178Y leukemic cells which rapidly develop and lose implantation ability.


Sudden drop in alcohol and drug related traffic deaths in Puerto Rico - 1974.


Intrapericardial teratoma: a cause of cardiac tamponade in infancy.


Attenuated influenza virus intranasal vaccine in a high risk male population.


A new approach to the study of immunity to schistosomes.


The president's New Year message.

The president's New Year message.


Severe hypodontia of the permanent dentition with bilateral dilated odontomes in the upper lateral incisor region. A case report.


Early neoplastic change related to a denture identification mark.


Salivary gland radiology.

Salivary gland radiology.


Private practice in N.H.S. hospitals.

Private practice in N.H.S. hospitals.


Letter: Inhalation sedation for conservative dentistry.


Letter: Practical use of materials and in vitro experiments.


Letter: Proxime stat.

Letter: Proxime stat.


Letter: Claims for fluoride toothpaste.

Letter: Claims for fluoride toothpaste.


Letter: Fluoridation.

Letter: Fluoridation.


Letter: Take thought for the morrow.

Letter: Take thought for the morrow.


Letter: Magnifying lens attachment for spectacles.


Letter: Packing composite filling materials.


Letter: State abuse of dentistry.

Letter: State abuse of dentistry.


Letter: The selection of dental students.


The action of fluoride in caries prevention. A review of current concepts.


Editorial: Is the profession oriented toward health or disease?


Letter: Drug treatment affecting the management of dental patients.


Letter: A field trial in preventive dentistry.


Letter: Dental pain.

Letter: Dental pain.


Letter: The seal of root fillings at apicoectomy.


Fissure sealing by practitioners. First year retention data in Scottish 6-year-old children.


Oral hygiene instruction in children using manual and electric toothbrushes. Benefits after six months.


Preventive dentistry in general practice. A study of current use.


Post-mortem pigmentation of teeth.

Post-mortem pigmentation of teeth.


The economics of fluoridation.

The economics of fluoridation.


Editorial: To be continued.

Editorial: To be continued.


Association for Dental Education in Europe.


Editorial: A pressing problem.

Editorial: A pressing problem.


Regional nerve block for maxillary permanent molars.


An orthodontic challenge.

An orthodontic challenge.


Mechanical properties of composite restorative materials.


Corticosteroids and the exposed pulp.

Corticosteroids and the exposed pulp.


Design for dental health education.

Design for dental health education.


Drinking and problems from drinking after a reduction in the minimum drinking age.


Recurrent ranula. A case report.

Recurrent ranula. A case report.


Elaborations on the meaning of repetitive behavior in drug dependent personalities.


Proceedings: Genetic markers and the origin of human neoplasms.


Proceedings: The pattern of malignant lymphoreticular cell proliferation and its relevance to chemotherapy.


Proceedings: Cell mediated cytotoxicity (CMC) in patients with acute myeloblastic leukaemia receiving immunotherapy.


Immunotherapy in the management of acute leukaemia.


Cell proliferation and protein synthesis in human leukaemic myeloblasts after cytosine arabinoside therapy. The effect of a single intravenous bolus injection of cytosine arabinoside (ARA-C) on the cytokinetics and 3H-leucine uptake of leukaemic myeloblasts in bone marrow and blood was studied at intervals up to 96 h after ARA-C in five patients with previously untreated acute myelogenous leukaemia. An early decrease in mitotic index and in 3H-thymidine labelling was observed in four of five patients and pretreatment values were reached again within the observation period. Changes suggesting synchronization were not observed. ARA-C induced a marked decrease in protein synthesis in the leukaemic myeloblasts as estimated from either a decrease in the 3H-leucine labelling index or the mean grain count of 3H-leucine labelled cells. It is suggested that ARA-C is incorporated also by cell which are not in S-phase and has a prolonged biochemical effect on the leukaemic cells.


Report from MDHA representative to Advisory Council on Professional Relations to Delta Dental Plans of Michigan.


The elusive employement contract.

The elusive employement contract.


MDHA formulates interim policy statements.


The survey of dental hygiene in Michigan: a preliminary report.


Preventive dentistry: fad and facts.

Preventive dentistry: fad and facts.


The hemodynamic basis of atherosclerosis. Further observations: the bifurcation lesion.


The invisible ocular map.

The invisible ocular map.


Organ-cultured human corneas.

Organ-cultured human corneas.


Curare, an aid in the surgery of cataract.


Toxicity of local anesthetics in the fetus and the newborn.


Effects of local anesthetics administered to parturient women on the neurological and behavioral performance of newborn children.


The effect of local anesthetics on fetal heart rate.


Acute leukaemia after four years of melphalan treatment for melanoma.


Toxicity of doxorubicin and methotrexate in osteogenic sarcoma.


Stress related recovery from lateral hypothalamic aphagia.


Letter: Isolation of patients with bone marrow depression.


Chromosomes and causation of human cancer and leukemia. XI. Correlation of karyotypes with clinical features of acute myeloblastic leukemia. Acute myeloblastic leukemia (AML) patients with chromosomal abnormalities in their bone marrow cells were divided into those with minor karyotypic abnormalities (MIKA) and those with major karyotypic abnormalities (MAKA). One of the largest subgroups in the MIKA group was shown to have cytologic characteristics typical of so-called "classical" AML and a "prototypic" karyotype, which has been shown to be due to translocation between chromosomes number 8 and number 21. A missing Y chromosome in AML was mostly associated with this karyotype. Patients of the MAKA group were usually erythroleukemic, had no or very few normal metaphases among the abnormal ones in the marrow, and almost invariably showed karyotypic instability. Karyotypic differences did not affect the patients' survival after the initiation of chemotherapy as much as did the presence or absence of normal metaphases. However, the karyotypes do appear to be relevant to the decision as to whether a patient should be administered chemotherapy when no normal metaphases are found on the initial bone marrow examination.


Serial observations on terminal deoxynucleotidyl transferase activity and lymphoblast surface markers in acute lymphoblastic leukemia. Terminal deoxynucleotidyl transferase activity and cell surface markers were measured in peripheral lymphoid cells from 27 children with acute lymphoblastic leukemia in various phases of their disease. Lymphoblasts from untreated patients had smooth surface ultrastructure but heterogeneous surface receptors. Greater than 60% of lymphoblasts from 4 to 7 untreated patients formed rosettes with sheep red blood cells. Transferase activity was variable, ranging from 8 to 210 units/10(8) blasts, but it was consistently elevated at diagnosis and in relapse. Transferase levels did not correlate with the presence of lymphoblast surface receptors. During induction therapy transferase activity decreased rapidly, but it remained elevated in peripheral lymphoid cells even when blasts were not detectable in peripheral blood smears. Patients in remission had normal surface receptors and undetectable or minimally elevated levels of transferase. Terminal transferase activity may be a sensitive biochemical marker for a primitive cell population and may be important in the evaluation of therapeutic effectiveness in acute lymphoblastic leukemia.


Hypersensitive reactions and antibody formation during L-asparaginase treatment of children and adults with acute leukemia. One hundred and fourteen patients with acute leukemia, 57 children (10 AML and 47 ALL) and 57 adults (37 AML and 20 ALL) were treated with L-asparaginase (Asnase) 200 or 1000 IU/kg daily for 30 days unless withdrawn on account of side effects. Combinations with other cytotoxic drugs were used in all but eight patients. Hypersensitive reactions, decrease in Asnase activity in plasma, and bivalent antibodies to Asnase appeared more frequently in adults (28%, 46%, and 79%, respectively) than in children (16%, 17%, and 25% respectively). There was a clear association between these three parameters. Thus hypersensitive reactions generally developed at the time of or after the decrease in plasma Asnase activity. Antibodies were detected only where Asnase activity had disappeared from the plasma. This time sequence, and in vitro experiments, suggest the formation of antigen-antibody complexes which might be responsible for inactivation of Asnase and for the development of hypersensitive reactions. However in many cases antibodies were found without concomitant enzyme inactivation or hypersensitive reactions. Antibodies to Asnase of IgE type (reagins) were found in only 10 children and 6 adults. There was no correlation between hypersensitive reactions, decrease in Asnase activity, and IgE antibodies. The frequency of remission among patients developing bivalent antibodies to Asnase was 68% (13/19) in contrast to 27% (3/11) among patients whose sera contained no detectable antibodies to Asnase, but the difference was not statistically significant.


Caries and dental fluorosis in Cuban children.


Effect of slivary agglutinins on bacterial colonization of tooth surfaces.


Establishment and symbiosis of Actinomyces viscosus, Streptococcus sanguis and Streptococcus mutans in germ-free Osborne-Mendel rats.


Influence of water fluoridation on the eruption of permanent teeth.


Effect of fluoride tablets on uptake and loss of fluoride in superficial enamel in vivo.


Control of purine biosynthesis in normal and pathologic states.


Some cases of Type III glycogen storage disease. Five patients with glycogen storage disease are described. Hypoglycemia was observed in all patients after an overnight fast, and glycemic and lactatemic curves obtained after oral administration of glucose or galactose were typical of those seen in Type III glycogenosis. An increase of liver glycogen up to 12-16% and complete absence of liver amylo-1,6-glucosidase were found in liver tissue samples obtained by needle biopsy. The patients were diagnosed as having Type III glycogenosis. In two patients the absence of amylo-1,6-glycosidase was accompanied by a sharp decline of liver phosphorylase activity. In one patient a decline of glucose-6-phosphatase activity was observed. The structure of liver glycogen was different in different patients, and so were the types of glycemic and lactatemic curves obtained upon protein tolerance tests. The above phenomena might be explained by some secondary disturbances in the activity of enzymes (phosphorylase, glucose-6-phosphatase) involved in the metabolism of liver glycogen of these patients.


A reassessment of demecolcine ('Colcemid') in the treatment of chronic granulocytic leukaemia.


Alveolar bone loss in the permanent first molars of Norwegian schoolchildren receiving systematic dental care. A distance exceeding 2 mm from the cementoenamel junction (CEJ) to the alveolar bone was observed on the proximal surfaces of the first molars of proportionally more 15-year-olds (101 subjects) than 13-year-olds (99 subjects). The measurements were performed on bitewing radiographs, and the methodologic error amounted to 3%. Recordings in excess of 2 mm were most frequent (0.27 and 0.23) for the distal surfaces of the maxillary molars.


Reliability of caries data in three clinical trials. The reliability of caries data obtained during three clinical trials is presented. Each of the three trials, conducted by different examiners, lasted 3 years and involved children aged 12 to 15 years. Reliability was quantified in terms of reliability coefficient and error variance, which allowed the effect of error upon the efficiency of each study to be measured. Reliability tended to be reduced when precaviation (initial) lesions were included in the DMFS count, but there was little difference between the reliability coefficients for each of four different surface-types. Error was more important in 3-year incremental rather than prevalence data, but nevertheless had a rather small influence upon sample size estimation or confidence limits of percent caries reductions.


Department of Community Dentistry, University of Florida College of Dentistry, Gainesville, Florida. The oral health status of 454 children and 115 adults from a population of migrant and seasonal farmworkers in Florida was assessed. The prevalence of disease among the children was consistent with that reported for other black children of this age. The migrants had received more dental treatment than the children of seasonal farmworkers; however, the level of care for both groups was strikingly low. The results of this neglect were clearly reflected in the mouths of the adults, most of which were found to be in a very deteriorated state of dental health. A program to cope with these long unmet needs is unrealistic. Efforts should be made to eliminate pain and infection until the cycle of poverty can be broken.


Periodontal condition in Turkish recruits. The periodontal condition of 300 Turkish troops was investigated using the modified Ramfjord Periodontal Disease Index. In addition, the gingival condition, presence and quantity of plaque and calculus, location and depth of periodontal pockets, tooth mobility, presence and severity of wear facets, diastema magnitude and the DMFT Index were determined. The average PDI was 3.8. Nearly 98% of the recruits suffered from gingivitis, 68% of whom exhibited moderate to severe inflammation without involvement of deeper structures. Moderate plaque accumulation and heavy calculus deposits were observed. An average DMFT of 5.09 was found. Little correlation was found between the relatively low DMFT rate and the Plaque Index.


Emergence of permanent teeth and onset of dental stages in the population of Iceland. The purpose of this investigation was to determine the mean ages at emergence of the permanent teeth of Icelandic children, as well as the mean ages at onset of the dental stages (DS). The material consisted of 1,941 randomly selected children, corresponding to 9.5% of the total primary and secondary school population of Reykjavik. The mean ages at emergence of the permanent teeth, along with the ages at commencement of DS 2, DS3, DS4 and DS M2, are given. Owing to the age distribution of the material, it was not possible to give mean ages at emergence of the first and third molars, or of the mandibular central incisors. A comparison of the emergence-ages in Icelandic children with those of Danish and Norwegian children showed close agreement.


Anti-caries effect of a 2% Na2PO3F-dentifrice in a Danish fluoride area. A 3-year experimental toothbrushing study was conducted in a natural fluoride area in Denmark to evaluate the anti-caries effect of a 2% sodium monofluorophosphate dentifrice. In a previous report the results for the total population of 1,407 schoolchildren, representing a broad age-span (7-12 years), at the commencement of the study in 1970 were given. In the present report results are presented for two subpopulations of "8-year-olds" and "11-year-olds" at the commencement of the study. Differential analysis of the effect of the test dentifrice on defined types of surfaces for the two subpopulations is given. The evaluation was performed using both the conventional DMF-indices and the recently published ECSI-Index6. The evaluation showed that the test dentifrice had a valuable anti-caries effect in both age groups, above and beyond the effect of the waterborne fluoride. Proximal surfaces were affected most baneficially by the active agent both in relative and absolute terms. However, an appreciable caries-preventive effect was also found on the "pit and fissure" surfaces.


Radioimmunoassay for human calcitonin employing synthetic calcitonin M: its clinical application. A sensitive and reliable radioimmunoassay for human calcitonin was described and applied to preliminary clinical studies. 125I-labelled synthetic human calcitonin M was purified by gel filtration with Sephadex G-25 and G-100. A nonequilibrium incubation system was applied at the final volume of incubation mixture of 500 mul, in which pooled plasma from normal subjects or hormone free serum was used as carrier protein at 20% incubation mixture. Dextran T 40 coated charcoal, resuspended in 1% bovine serum albumin buffer, was used for the separation of free from bound tracer. This showed the least nonspecific adsorption of tracer to charcoal. The assay was sensitive to 0.1 ng per milliliter of plasma. Recovery of synthetic human calcitonin added to plasma was found to be 101% (S. D., +/- 8). Diluted plasma from a patient with medullary thyroid carcinoma showed a dilution curve parallel to standards. Basal calcitonin levels were less than 0.3 ng/ml in normal subjects. Relatively high values were found in patients with chronic renal failure and in patients with malignant tumors. Extremely elevated values were found in patients with medullary thyroid carcinoma. Provocative calcium infusion tests were also performed.


Amniocentesis: a case study in the management of "genetic engineering".


Plastics in operative dentistry.

Plastics in operative dentistry.


Giving--the true joy of living.

Giving--the true joy of living.


The A.D.A. answers its critics.

The A.D.A. answers its critics.


How to hold a dental assistant (without a rope).


Playing with fire in your office?

Playing with fire in your office?


Fourth hand information: office management.


Makings of malpractice: pomp and circumstance.


Hygienist hotline.

Hygienist hotline.


On control.

On control.


Patient care for the 1970's.

Patient care for the 1970's.


Mucogingival repairs in periodontal surgery. The utilization of partial thickness apically repositioned flaps, laterally repositioned flaps, and free mucosal autografts enable the clinician to repair most mucogingival problems. These techniques may be used separately or in combination to increase the zone of attached gingiva, deepen the vestibular fold, and eliminate muscle and frenum pulls. If basic surgical principles are adhered to, the possibilities of repair of mucogingival problems utilizing these procedures are unlimited. The most important step in mucogingival surgery is planning the surgical procedure prior to beginning surgery. In this way different techniques may be combined to achieve the desired result and minimize the number of surgical episodes that may be required. It is important to conserve tissue. For example, tissues from gingivectomy or flap surgery in one area may be utilized for a free gingival graft in another area (Fig. 21). There is one last but most important requirement for mucogingival surgery: there should be some evidence of periodontal pathology. The lack of a wide zone of attached gingiva, the lack of a deep vestibule or a frenum pull is not in itself an indication for surgical intervention ulness some periodontal pathology is evident. In some cases it may be determined by the clinician's judgment that it would be best to perform a mucogingival surgical procedure to prevent one of these areas from developing into a periodontal problem. This decision is often dictated by the patient's age. In older patients, areas of minimal attached gingiva and shallow vestibular depth that show no periodontal breakdown should be regarded as areas of health and no surgical intervention is indicated. On the other hand, if these areas are evident in a child, particularly when orthodontic therapy is anticipated, then surgical intervention may be advisable to prevent serious damage to the gingival tissues.


Gingival recession. The condition, process, and treatment. The condition of gingival recession with its attendant patient complaints and additional professional concerns has been distinguished from the process of recession of the gingiva which has an obscure etiology. It has been suggested that the complaints and concerns regarding gingival recession be treated directly when they occur. Deviation from the expected anatomical form is not considered to be an excuse for therapy. The importance of the anatomical factors of alveolar bone dehiscence (long gingival fiber attachment) and lack of attached gingiva (absence of the fiber barrier) is not known. However, the current modailties of treatment have been examined in light of these hypotheses. Clearly, the effects of these anatomical factors on the process of recession of the gingiva need to be investigated.


Flap curettage: rationale, technique, and expectations.


Principles in periodontal osseous resection. In the clinical treatment of periodontal disease, the therapist should set definite goals so that he will know what to expect in a completed case. The goal of surgical intervention is certainly the elimination of the periodontal pocket. This is an obtainable objective. The therapist must understand normal periodontal morphology, thin margins, cone-shaped interdental papillae, and the interdental grooves blending into a harmonious periodontium. With this knowledge, he can surgically alter the tissue to achieve the desired architectural result. Restoration of the structures to healthy, maintainable contours is the ultimate success of his efforts. In many cases, osseous resection provides a mode of treatment that is predictable. It has become a basic procedure in periodontal therapy after more than 25 years of widespread clinical use by a large number of therapists.


Osseous surgery--how much need we compromise? It is essential that the execution and results of osseous surgery be carefully analyzed. Perhaps the two most compelling reasons are (1) that we should understand the effects on tooth mobility and their implications for complex restorative dentistry, and (2) to facilitate the accurate assessment of postoperative "success," bearing in mind not only improvement of the environment, but also increased chances of survival for the operated teeth. We have discussed the effects of osseous surgery on tooth mobility. In the light of recent information, a more accurate assessment of the need for splinting can be made. There has always been some controversy about osseous recontouring. Of late, there has been a particular resurgence of scepticism as to the efficacy of osseous resective procedures compared with more conservative forms of therapy. Scientific investigation demands the doubting mind and the analytical approach in order to establish the truth or fallacy of current ideas. This approach is essential to the continued existence of periodontics as a clinical science. These investigations should be based on a full understanding of the therapeutic measures being investigated, as it is misleading to assess the results of a procedure when that procedure is either not used to its full advantage or inappropriately used. It is hoped that these comments will be helpful in deciding whether definitive osseous correction in a given case is desirable or possible, in terms of both bone removal and permanent splinting. The author also hopes that this article has served to enhance the possibilities of more complete osseous correction when indicated, in order to achieve minimal pocket depths, and to permit proper comparison with other modes of periodontal therapy. It is, however, crucial to realize that whatever modality of therapy utilized, it is merely one phase in the treatment spectrum. Maintaining a stable state for the patient over many years is the ultimate goal, beside which any given technical procedure pales in significance. Periodontal therapy is an ongoing process in which patient recall plays a central role.


Rationale for the lingual approach to mandibular osseous surgery. The definitive treatment of periodontitis for pocket elimination and the establishment of periodontal architecture that can be effectively maintained with daily personal oral hygiene techniques is sometimes an elusive goal. Performing osseous reduction, primarily from the lingual aspect of the posterior mandible, definitely helps in accomplishing such a goal. This paper should not be interpreted to mean that osseous correction of bony defects should be approached strictly from the lingual, since almost all cases require some buccal recontouring if a satisfactory soft and hard tissue architectural form is to be achieved. Clinical observation and experience have shown that the anatomical patterns, seen in relation to the mandible, have a powerful effect on normal periodontal architecture as well as the types and locations of bony defects encountered. Tooth to bone relationships deserve attention. The buccal housing of the alveolar bone is frequently thin in the premolar region and occasionally on the first molar, while the external oblique ridge causes thicknened bone over the second molar. The vestibular depth on the buccal of the molars is often quite shallow, meaning that only a very limited amount of osteoplasty-osteoectomy can be performed from the buccal. The lingual housing of the alveolar bone is normally thickened and shelf-like from the distal of the third molars to the mesial aspect of the premolar region. Because the posterior teeth are inclined lingually from the second premolar distally, the buccal marginal bone height is higher occlusally than the lingual bone margins, with the interproximal bone therefore sloping somewhat apically and lingually. Interdental craters are the most common defect seen with the onset of periodontitis. Such defects in the lower arch tend to occur beneath the contact areas of the teeth, which are much further to the lingual than in the maxilla. The highest percentage of interproximal craters are shallow and not amenable to grafting techniques in the hands of most clinicians. These shallow craters are prime candidates for osseous reduction techniques. With the progression of periodontitis, the interproximal defects frequently extend to include infrabony lingual defects. Although obtaining lingual access for osseous reduction techniques is often difficult, osteoectomy-osteoplasty techniques performed primarily from the buccal of the posterior mandible frequently result in compromise of the lingual and over treating the buccal in terms of osteoectomy procedures. The lingual embrasure spaces are usually wider than on the buccal, and with adequate reduction of the mylohyoid ridge, greater access for oral hygiene procedures is provided.


Trustee's report: House expands Council's duties.


Graduates enter practices, Army.

Graduates enter practices, Army.


Onco-foetal cross reactivity between human osteogenic sarcoma and foetal periosteal fibroblasts grown 'in vitro'.


Evaluation of general immune responsiveness in cancer patients.


Weekly staff clinicopathologic conference of Postgraduate Institute of Medical Education and Research, Chandigarh.


The philosophy underlying the use of the Crozat appliance.


Leukocyte labeling with technetium-99m.

Leukocyte labeling with technetium-99m.


Letter: Evaluation of antimony-117 for tumor imaging.


The biology of human cells in tissue culture. I. Characterization of cells derived from osteogenic sarcomas. We have extensively characterized cell lines derived from six human osteosarcomas. The growth properties of these cultures were compared to those of fibroblastic cultures derived from skin of osteosarcoma patients and skin of bone-marrow of normal individuals. Each tumor-derived line showed some but not all of the abnormal growth properties usually associated with malignant transformation, indicating that tumor cells rather than normal stromal cells had in fact been cultured. The parameters measured included saturation density, cell morphology, growth pattern, growth on contact inhibited monolayers of normal fibroblastic or epithelial cells and tumorigenicity in immunosuppressed mice. Although the skin fibroblasts from the osteosarcoma patients appeared normal in vitro, they showed a greater ability to grow in immunosuppressed mice than did normalfibroblasts. This observation suggests that all fibroblasts of osteosarcoma patients may have an increased propensity for malignant transformation.


Is the F.R. the answer? (functional regulator).


The distal driver.

The distal driver.


Editorial: Time for a change.

Editorial: Time for a change.


Clines in the colour polymorphism of Philaenus spumarius in Eastern Central Europe. Populations of Philaemus spumarius (Homoptera) have been investigated in the Baltic States of the USSR, in Czechoslovakia and in Hungary. Colour morph frequencies in these highly polymorphic populations are compared with those reported earlier from northern Italy. Gradual changes in allele frequencies (clines) transect the study area, which lies in the most central part of the range of Philaenus in Europe. From north to south the allele pM increases, but pO decreases, in frequency. In their distribution, some of the other alleles also showed regional gradients. The possibility that visual selection varies regionally is dismissed on indirect grounds. Gradients in climatic severity, or in other environmental variables changing concomitantly with climate, are regarded as the primary cause of the observed clines and other differences between regions.


A sex-chromosome hybrid zone in the grasshopper Podisma pedestris (Orthoptera: Acrididae). Podisma pedestris exists as both an XO and neoXY form in the Southern French Alps. These chromosome types are shown to be contiguously allopatric and hybrid populations have been located in several places. Hybridisation appears to be occurring freely, but the hybrid zones are quite narrow. In several places the two distributions are separated by geographic barriers such as high mountain ridges and lowlands. The history of this XY chromosomal race is discussed in the light of the genetic dynamics of hybrid zones and the biogeography of this situation. Its origin is probably post-glacial, and it may be extending its range as a salient in one region. A comparison of the porperties of similar cases indicates that the formation of such chromosomal races may be a frequent event in relatively immobile species that are subjected to isolation and expansion by major climatic and ecological changes.


Food induced esterase phenocopies in the snail Cepaea nemoralis. Hepatopancreatic extracts from the snail Cepaea nemoralis, assayed straight from the field, often contain three or four heavily staining esterase zones which migrate to the cathodal end of polyacrylamide disc gels during electrophoresis. Previous breeding results showed that the heavily straining zones appeared allelic but to incorporate these multibanded phenotypes, a super gene of five closely linked loci was tentatively proposed. Further breeding work again failed to demonstrate multiple zones in parents or offspring and so experiments were conducted to see whether the multi-zoned phenotypes in the wild were produced by secondary modification of single primary products. Wild snails yielding extracts containing more than two heavily staining zones were shown to possess only two such zones after three months under laboratory conditions. Also, the ingestion of nettle (Urtica dioica L.) has been demonstrated to induce extra esterase zones in laboratory-reared animals. Some of the secondarily induced zones appear identical in physical, biochemical and electrophoretic properties to the primary products of other alleles, and thus appear to be electrophoretic phenocopies. A model is suggested which could account for this phenomenon.


Proceedings: Karyotypic transformation of chronic granulocytic leukaemia.


Proceedings: Chronic myelomonocytic leukaemia.


Fluorescein angiography of free gingival autografts. The capillary blood circulation of free gingival autografts during healing was studied by means of 45 fluorescein angiographs taken over a postoperative period of 14 days in 10 female patients, 21 to 36 years old. The surgical technique commonly used for transplanting gingiva was slightly modified in that no surgical dressings and, in 3 cases, not even sutures were employed to immobilize the grafts. During the first 3 postoperative days, fluorescent plasmatic diffusion of increasing intensity was observed. In one case, fluorescing capillary circulation was detected as early as 24 hours after surgery, fluorescent capillaries became evident in all graft sites and increased steadily in number. Between 9 and 14 days after surgery, an even capillary loop pattern was established.


Folic acid binding protein in acute myeloid leukaemia. Folic acid binding protein was estimated in the serum of 94 control subjects and a normal range was established. Raised levels were found in folate deficiency and chronic myeloid leukaemia. Considerably raised levels were found in untreated acute myeloid leukaemia, most often in cases with a marked monocytic element.


Control of normal differentiation of myeloid leukemic cells. X. Glucose utilization, cellular ATP and associated membrane changes in D+ and D- cells. Glucose utilization, energy metabolism and associated membrane changes, have been studied in D+ myeloid leukemic cells that can be induced to undergo cell differentiation to mature granulocytes by incubation with the appropriate conditioned medium (CM) and in D- myeloid leukemic cells that cannot be induced to differentiate to mature cells. Before incubation with CM, glycolysis and the glycolytic production of ATP were lower and the activity of the pentose cycle was higher in D+ than in D- cells. ATP depletion induced a higher degree of agglutination by concanavalin A in D- than in D+ cells, indicating a difference in their surface membrane. There were no detectable differences in the transport of glucose and the synthesis of sterols and fatty acids. After incubation with CM, the D+ cells, like normal granulocytes, showed a higher glycolysis, produced their ATP more through glycolysis than oxidative phosphorylation, became less dependent on the exogenous supply of glucose and oxygen and had a lower rate of sterol and fatty acid synthesis. The differentiating D+ cells also showed a change in their surface membrane resulting in an increased agglutinability without a change in ATP content and a stimulation of the pentose cycle by concanavalin A. These properties, which were not acquired by D- cells, were found before most of the D+ cells had differentiated to mature granulocytes. The data indicate, that the block in the ability of the D- cells to differentiate and the acquistion of the metabolic properties of normal granulocytes by differentiating D+ cells, were associated with differences in the organization of the cell surface membrane.


The zone of completely and partially destructed periodontal fibres in pathological pockets. The morphology, the width and the appearance frequency of the zone completely and partially destructed periodontal fibres on human teeth were studied in the stereomicroscope. This zone was present between the most apical border of identifiable, epithelial attachment remnants and the most coronal intact periodontal fibres, and consisted of only a few fibres without any specific orientation. The mean width of the zone was 0.43 mm, and the appearance frequency almost 100%. The results of the comparison between clinical and laboratory pocket depths indicated that the pocket depths measured in the laboratory were always less deep than those recorded clinically. There seemed to be a relationship between these findings and the presence of a zone of completely and partially destructed periodontal fibres.


A radiographic study of the prevalence of chronic periodontitis in 14-year-old English schoolchildren. The prevalence of chronic periodontitis was investigated in six hundred and two 14-year-old English schoolchildren using a standardised radiographic technique. The interproximal spaces on the mesial and distal aspects of the first molar teeth were examined. Oral cleanliness and gingivitis for the anterior teeth and caries prevalence were also recorded. Radiographic evidence of chronic periodontitis was detected in 51.5% of the children examined. No significant relationship was demonstrated between bone loss associated with the first molars and any of the other parameters measured.


Plaque-free zones on human teeth in periodontitis. The surface morphology of the pocket area of extracted, periodontally involved, human teeth was studied with steromicroscope. A plaque-free zone was found to be present in all specimens. The width of the plaque-free zone was found to decrease as the pocket depth and loss of attachment increase.


A radiographic method for assessing changes in alveolar bone height following periodontal therapy. A method is described for obtaining reproducible radiographs of several groups of teeth in the same jaw. The method was applied to assess changes in the alveolar bone height following periodontal treatment. An oral device was designed to permit direction of the central rays of the beam perpendicularly to the alveolar process in different parts of the jaws. The exposures were made at 60 kVp and 10mA, and standardized procedures were used for developing, fixing and rinsing the films. Alterations in the marginal alveolar bone level were determined in a stereocomparator system. The reproducibility of the method was determined. A pilot experiment was performed on 5 patients with periodontal disease. Following conservative treatment, including scaling and root planning, all patients were subjected to periodontal surgery, including alveolar bone denudation. Radiographs of the alveolar bone were obtained before and 2 months after the operation. By measuring in the stereocomparator parallaxes of both control points and points of the alveolar bone crest on paired radiographs, a mean decrease in interproximal alveolar bone height of 0.69 mm was found. Taking into account the small errors which are inherent in the method, this change in bone height could be regarded as a reliable measure of actual loss of bone.


The need for periodontal treatment in an urban population. The need for periodontal treatment was estimated in a group of the citizens of Oslo. A considerable treatment need was found in spite of the high dentist/population ratio in the area. The need for surgical treatment increased with age. Estimated treatment time was higher in males than in females.


Testing therapeutic measures for controlling chronic gingivitis in man: a suggested protocol. A protocol is presented for the clinical evaluation of agents used to control chronic gingivtis in man. Assessment is divided into three phases of increasing duration which are the initial screening of products over 1 month, the main gingivitis trial lasting at least 6 months and judging the effect of the product in preventing periodontitis which is extended for at least 3 years. The advances in data processing have made it possible to collect information separately on the three parameters of gingival inflammation.


Bone regeneration following damage by polysulphide impression material. A case report. Two days after polysulphide rubber impressions had been taken of gold inlay cavities in 6 and 7, a 22-year-old female dental student developed a painful swelling between 5 and 6. A radiograph revealed the presence of an irregular radiopaque body within the cancellous bone of the interdental septum between 5 and 6. At operation, 1 month later, the interdental septum was seen to have been destroyed and its position occupied by impression material and inflammatory tissue. When the lesion was reopened 2 years later to correct slight recurrent pocketing, significant regeneration of bone was found to have occurred.


The present status of the gingivectomy procedure. The use of the conventional gingivectomy procedure is indicated to achieve optimum gingival contour and to eliminate supra-alveolar pockets where these do not extend beyond the muco-gingival junction. The instrument of choice for the procedure is a gingivectomy knife. Where a blood-free field is required, electrosurgery may be used provided the instrument is not brought into contact with bone. The maintenance of good oral hygiene is essential.


Optimal layout of surfaces, MODFL, on record forms.


Advanced dental education-a time for mandatory general practice residencies.


Editorial: Federal intervention in universities.


Variables affecting attitudes of dentists toward the use of expanded function auxiliaries. A questionnaire survey of over 500 dentists in upstate New York was conducted to determine the following: (1) the extent to which the dentists understood the recent changes in the State Dental Practice Act as it applies to expanded functions of dental hygienists and (2) the attitudes and beliefs of these dentists regarding the use of hygienists and dental assistants in the performance of expanded duties in the private office. In general, the respondents were not familiar with the recent changes in the Dental Practice Act. When the respondents who employed dental hygienists were compared to those who did not employ hygienists, the differences regarding understanding of the changes in the act were not striking.


The part-time dental educator.

The part-time dental educator.


Educational value of a university-sponsored community dental clinic: a three year student evaluation. The overall assessment of the clinic experience by the students was positive. Response to the open-ended questions showed that a number of students took pride in the Venice clinic and that they gained a great deal of personal and professional satisfaction from being able to provide service to people in a low-income and minority community. Almost 90% stated that their understanding of health problems of the poor was improved; 75% felt that their ability to relate to patients from different backgrounds was broadened; and 45% expressed more willingness to practice in a low-income area. This community setting also enlarged the scope of the students' clinical experience. Over 50% saw pathological conditions that they had not viewed previously. In addition, over 90% of the students did at least 50% more work, and over half of these performed twice as much treatment.


Perceptual learning: its importance in dentistry. Perceptual skills are essential to the acquisition of motor skills in dentistry. The absence of these perceptual skills should be determined as early as possible and should be rectified by instruction. Programed instruction is one suitable method for teaching these skills. Perceptual discrimination will allow the learner to picture his goal or objective clearly, and it will increase his motivation by enabling him to reach this goal. Perceptual skills are necessary too for the learner to improve his performance by repetitive practice, see his mistakes, and institute corrective behavior.


Systematic procedure for determining criterion scores. The present study describes a systematic method for determining a criterion score in criterion-referenced measurement. Reliable estimates were obtained by using only three judges who were subject matter experts. This demonstrates that the method can be applied to the test performance levels of individuals who are required to meet the objectives for a subject matter area. The present study showed that reliable judgments could be made even on subject matter of an advanced nature.


Comprehensive care in a year-round curriculum.


To die young, to die old management of terminal illness at age 20 and at age 85: case reports. Death and dying in a 20-year-old woman. An effort was made to provide emotional support during the terminal phase of leukemia in a 20-year-old woman. Notable were the patient's own ways of coping and the responses of her family and the hospital staff. She first denied and then recognized her own dying. Her anger was prominent, and she withdrew from objects toward the end. The intense stresses in the doctor-patient relationship, transference, countertransference, and reality factors are described.


Chronic myelomonocytic leukemia. A review.


Immunoglobulins in periapical granulomas: a preliminary report.


Anatomy of the pulpal canal: three-dimensional visualization.


Endotoxin content in endodontically involved teeth.


Role of the anesthetic solution in intrapulpal anesthesia.


Retrograde amalgam filling: a scanning electron microscopic study.


Herpes zoster associated with pulpless teeth.


Traumatized maxillary central incisor.

Traumatized maxillary central incisor.


Resection of two vital roots.

Resection of two vital roots.


Higher education in retreat.

Higher education in retreat.


Ethics and objectives in advanced dental education.


A scanning electron microscopic study of the efficacy of various endodontic instruments.


The role of council on dental education in advanced education in endodontics.


A comparison of the efficacy of serial preparation versus Giromatic preparation.


Presence of immunoglobulin-producing cells in periapical lesions.


Contamination of endodontic cultures by Staphylococcus epidermidis.


Systemic distribution of lead from root canal fillings.


Effect of instrumentation on the shape of the root canal.


Evaluation of two filling methods for root canals.


Dens invaginatus-type malformation without pulpal involvement.


Induced apical closure of permanent teeth in adult primates using a resorbable form of tricalcium phosphate ceramic.


Fractured root with internal resorption, repair, and formation of callus.


Sealing quality of instruments cemented in root canals with polycarboxylate cements.


Sealing quality of two polycarboxylate cements used as root canal sealers.


Incidence of antibiotic resistance in microorganisms isolated from root canals.


Diplomate status and the American Board of Endodontics.


Effect of aging on the human pulp.

Effect of aging on the human pulp.


Direct pulp capping of permanent teeth in primates using a resorbable form of tricalcium phosphate ceramic.


Filling of root canals with adhesive materials.


Modification of technique for injection obturation.


Rapid sterilization of gutta-percha cones with 5.25% sodium hypochlorite.


Traumatized maxillary incisors.

Traumatized maxillary incisors.


Nonsurgical repair of electrophoretically diagnosed radicular cysts.


Microorganisms from pulpal chambers of intact teeth with necrotic pulps.


Histologic observations of endodontically treated replanted roots.


Tooth germination treated by endodontic therapy.


Local effects of systemically administered oxytetracycline on healing after mechanically induced damage of pulp tissue in rats.


A preliminary scanning electron microscopic study of root canals after endodontic procedures.


Effect of irrigation on the production of extruded material at the root apex during instrumentation.


Delayed replantation of avulsed teeth.

Delayed replantation of avulsed teeth.


An intravenous sedation technic for moderate length dental procedures.


Pathologist's corner.

Pathologist's corner.


Guide to New Jersey courses.

Guide to New Jersey courses.


Letter: Diabetes insipidus as a presenting manifestation of acute myelogenous leukemia.